Anion gap predicts the long-term neurological and cognitive outcomes of spontaneous intracerebral hemorrhage

OBJECTIVE

To investigate whether anion gap (AG) can act as a potentially predictive biomarker in recoveries of neurological and cognitive functions.

PATIENTS AND METHODS

A total of 89 patients with intracerebral hemorrhage (ICH) were recruited. Of these, 68 and 21 patients were categorized into screening cohort and validation cohort, respectively. In the screening cohort, patients were categorized into three groups, according to the serum AG levels at admission. We dynamically recorded AG levels. Neurological and cognitive functions were assessed using Glasgow coma scale (GCS), Glasgow outcome scale (GOS) and mini-mental state examination (MMSE) scale at different time points. Furthermore, in the validation cohort, 9 patients with increased AG level underwent interventions to rectify the electrolyte imbalance.

RESULTS

In the screening cohort, statistical differences were observed for respiratory diseases (p=0.029) among the three groups. The number of patients in the ≥16 mmol/L group (59.3%) was higher than that in the other groups. The mean scores of GCS in the ≥16 mmol/L group were lower than those in the other groups. The AG levels at admission had significant associations with 180-day GOS (p=0.043) and 180-day MMSE (p=0.001). Among them, the mean scores of the 180-day GOS and 180-day MMSE were lower in the ≥16 mmol/L group than in the other groups. In the validation cohort, AG intervention promoted recoveries of neurological and cognitive functions when compared to those without AG interventions.

CONCLUSIONS

AG is a potentially predictive biomarker for the long-term outcomes of ICH patients, and rectifying AG at admission improves the outcomes.

Trabecular bone score and its association with Cobb angle kyphosis in older men: a cross-sectional study for the Osteoporotic Fractures in Men (MrOS) Study

Hyperkyphosis (HK), or accentuated forward spinal curvature, commonly affects older people, although its causes are not completely understood. We tested whether a measure of bone quality, trabecular bone score (TBS), is associated with HK in 1997 older men, and determined that men with degraded TBS were more likely to have HK.

INTRODUCTION

While vertebral fractures and low bone mineral density (BMD) contribute to kyphosis progression, it is unknown whether the trabecular bone score (TBS) may provide additional information on bone quality that could influence the degree of kyphosis. We hypothesized that degraded TBS would be associated with hyperkyphosis (HK) defined as a Cobb angle > 50°.

METHODS

Using data from 1997 participants of the Osteoporotic Fractures in Men (MrOS) Study who had baseline TBS and Cobb angle kyphosis measured, we investigated whether men with degraded TBS were more likely to be hyperkyphotic, even after adjustment for BMD and prevalent vertebral fractures.

RESULTS

Men were an average age of 74 ± 6 (mean ± SD) years with a mean kyphosis angle of 38.6 ± 11.5°, 295 (15%) were classified as hyperkyphotic, and 416 (21%) had degraded TBS. Compared with men with TBS > 1.2, men with degraded TBS were more likely to have HK (OR: 1.47, 95% CI: 1.06-2.06, p = 0.02) after adjusting for age, clinic, race, BMI, hip BMD, and prevalent vertebral fracture. If spine instead of hip BMD was included in the model, the odds ratio decreased to 1.35 (95% CI: 0.97-1.89, p = 0.08).

CONCLUSIONS

Older men with degraded TBS are more likely to have HK not explained by underlying vertebral fractures.

[miR-20a-5p inhibits proliferation of lung cancer A549 cells by down-regulating HOXB13]

OBJECTIVE

To investigate the molecular mechanism by which miR-20a-5p regulates HOXB13 gene expression and inhibits lung cancer cell proliferation.

METHODS

The expression levels of HOXB13 mRNA and protein in lung cancer A549 cells transfected with HOXB13 overexpression plasmid or HOXB13 siRNA were detected with real-time fluorescence quantitative PCR (qRT-PCR) and Western blotting. CCK-8 and EdU assays were used to examine the effect of modulation of HOXB13 expression on cell proliferation. We screened possible binding miRNAs of HOXB13 by bioinformatics analysis. In A549 cells transfected with miR-20a-5p mimic or miR-20a-5p inhibitor, the expression level of miR-20a-5p was detected by qRT-PCR and the protein expression of HOXB13 was determined with Western blotting. CCK-8 and EdU assays were used to assess the effect of miR-20a-5p overexpression on the proliferation of A549 cells. miR-20a-5p mimic and HOXB13 overexpression plasmids were co-transfected into A549 cells, and the changes in cell proliferation were evaluated with CCK-8 and EdU assays.

RESULTS

HOXB13 overexpression obviously promoted the proliferation of A549 cells (P < 0.05). miR-20a-5p was identified as the potential binding miRNA of HOXB13. Overexpression of miR-20a-5p in A549 cells significantly decreased the expression of HOXB13 protein (P < 0.05), while interference of miR-20a-5p obviously increased HOXB13 expression (P < 0.05). The results of cell proliferation experiment showed that miR-20a-5p and HOXB13 had opposite effects on cell proliferation, and the cells overexpressing both miR-20a-5p and HOXB13 showed a lower proliferation activity than the cells overexpressing HOXB13 but higher than the cells overexpressing miR-20a-5p alone (P < 0.05).

CONCLUSION

miR-20a-5p inhibits proliferation of lung cancer cells by down-regulating the expression of HOXB13.

Effects of Atomoxetine Hydrochloride on Regulation of Lifespan in Drosophila Model

Nootropics (smart drugs) are used by students to enhance cognitive performance which have been reported times in recent years. However, some of the nootropics are central nervous system stimulants which are very likely to lead to addiction or complications such as vomiting and dizziness. Are there nootropics that can improve learning behavior while having potential positive effect on health? Here, we reported that Atomoxetine (ATX) has sex-specific effect on prolonging the life span of female Drosophila melanogaster. Further study indicated that ATX enhanced female resistance to heat stress and their vertical climbing ability, but it did decrease the number of eggs laid. ATX increased food-intake and sleep time both of females and males, and significantly reduced the 24h spontaneous activity of females and males. Our results present the sex dimorphic effect of ATX on life span regulation in Drosophila, and support further research on the beneficial role of ATX and the mechanisms in other animal models.

DEEP Study: Modeling Outcomes and Costs of Persistent Orofacial Pain

KNOWLEDGE OF TRANSFER STATEMENT

Despite a substantial number of consultations, individuals experiencing the care pathways in this study continued to have far from perfect health over their life course. The modeling suggests they would only experience 18 y in "perfect health." There is considerable scope to improve current care/outcomes and patient experience.

Three Novel Structural Variations at MHC and IL12B Predisposing to Psoriasis

BACKGROUND

Structural variations (SVs, defined as DNA variants ≥50 bp) have been associated with various complex human diseases. However, research to screen the whole genome for SVs predisposing to psoriasis is still lacking.

OBJECTIVES

This study aimed to investigate the association of SVs and psoriasis.

METHODS

We performed a genome-wide screen on SVs using an imputation method on 5 independent cohorts with 45,386 subjects from the Chinese Han population. Fine mapping analysis, genetic interaction analysis and RNA expression analysis were conducted to explore the mechanism of SVs.

RESULTS

We obtained 4,535 SVs in total and identified 2 novel deletions (esv3608550, OR=2.73, P<2.00×10^-308 ; esv3608542, OR=0.47, P=7.40×10^-28 ) at 6q21.33 (MHC), 1 novel Alu element insertion (esv3607339, OR=1.22, P=1.18×10^-35 ) at 5q33.3 (IL12B), and confirmed 1 previously reported deletion (esv3587563, OR=1.30, P=9.52×10^-60 ) at 1q21.2 (LCE) for psoriasis. Fine mapping analysis including SNPs and small Insertions/Deletions (InDels) revealed that esv3608550 and esv3608542 were independently associated with psoriasis, and a novel independent SNP (rs9378188, OR=1.65, P=3.46×10^-38 ) was identified at 6q21.33. By genetic interaction analysis and RNA expression analysis, we speculate that the association of 2 deletions at 6q21.33 with psoriasis might relate to their influence on the expression of HLA-C.

CONCLUSIONS

Our study constructed the most comprehensive SV map for psoriasis thus far and enriched the genetic architecture and pathogenesis of psoriasis as well as highlighted the nonnegligible impact of SVs on complex diseases.

LncRNA CASC19 contributed to the progression of pancreatic cancer through modulating miR-148b/E2F7 axis

OBJECTIVE

Cancer susceptibility 19 (CASC19), a crucial lncRNA associated with multiple cancers, has been reported to play a vital role in the progression of human malignant tumors. However, the underlying mechanism of CASC19 in pancreatic cancer (PC) was still unknown. The purpose of this study was to explore the biological and clinical significance of CASC19 in PC.

PATIENTS AND METHODS

RT-qPCR assay was adopted to analyze CASC19 expression in PC tissues and cell lines. Furthermore, the correlation between the CASC19 level and the survival rate of PC patients was assessed by Kaplan-Meier analysis. Bioinformatics analysis and Luciferase reporter assay were utilized to confirm the interaction between miR-148b and CASC19 or E2F7. Cell viability, migration, invasion, and apoptosis were analyzed using MTT, transwell, and TUNEL assays.

RESULTS

The results elucidated that CASC19 expression was markedly increased in PC tissues and cell lines. Patients with high expression of CASC19 had a short survival time. Silencing of CASC19 attenuated PC cell proliferation, migration, and invasion. Moreover, we identified that miR-148b was a target of CASC19. CASC19 was negatively correlated with miR-148b and positively correlated with E2F7. The inhibitory effect of CASC19 knockdown on the progression of PC was reversed by the down-regulation of miR-148b or up-regulation of E2F7.

CONCLUSIONS

These results demonstrated that CASC19 participated in the development of PC. The CASC19/miR-148b/E2F7 axis might be a new study direction for PC treatment.

[A case of decompression sickness complicated with multiple organ failure treated by hyperbaric oxygen therapy sequential with continuous renal replacement therapy and extracorporeal membrane oxygenation]

Objective: To discuss the new idea of on-the-spot recompression treatment and multidisciplinary treatment (MDT) for patients with unstable vital signs of type II decompression sickness. To provide reference for the nearby treatment of patients with critical decompression sickness. Methods: The clinical data of a case of a multi-disciplinary collaborative treatment of type II decompression sickness complicated with multiple organ dysfunction syndrome (MODS) admitted to a third-class A hospital in January 2020 were analyzed and summarized. Results: The patient suffered from consciousness disturbance and shock after 3 min of diver's blow-up out of the water. CT examination showed gas accumulation in the systemic multi-organ venous system, and laboratory examination suggested MODS. The oxygen inhalation regimen was given in the session of recompression treatmen by 0.12-0.18 MPa. Intravenous fluid was the total of 8900 ml in the session, and the total recompression treatment time was 9 h 45 min. The patient was still in unconscious when he finished the session. CT re-examination confirmed the elimination of venous bubbles, and laboratory examination indicated multiple organ failure (MOF) . The patient was given comprehensive supporting treatment by mechanical assisted breathing and following by continuons renal replacement therapy (CRRT) and extrocorporeal membrane oxygenation (ECMO) in the intensive care unit, and was discharged after 32 d of hospitalization. Conclusion: Critical decompression sickness patients with unstable vital signs are taken to a local general hospital with hyperbaric oxygen chamber and intensive care unit. The successful treatment can be achieved by organizing diving medicine, hyperbaric oxygen medicine and critical medical personnel for MDT.

Microemulsification of essential oils for the development of antimicrobial and mosquito repellent functional coatings for textiles

AIMS

To develop an essential oil (EO)-loaded textile coating using an environmentally friendly microemulsion technique to achieve both antimicrobial and mosquito repellent functionalities.

METHODS AND RESULTS

Minimum inhibitory concentrations and fractional inhibitory concentrations of litsea, lemon and rosemary EOs were determined against Staphylococcus aureus, Escherichia coli, Staphylococcus epidermidis, Pseudomonas aeruginosa and Trichophyton rubrum. A 1 : 2 mixture of litsea and lemon EOs inhibited all the microorganisms tested and was incorporated into a chitosan-sodium alginate assembly by a microemulsification process. The EO-loaded microemulsions were applied to cotton and polyester fabrics using a soak-pad-dry method. The textile challenge tests demonstrated 7-8 log₁₀ reductions of S. epidermidis, S. aureus and E. coli after 24 h and T. rubrum after 48 h. Aedes aegypti mosquito repellency was also assessed which demonstrated 71·43% repellency compared to 52·94% by neat EO-impregnated cotton.

CONCLUSIONS

Textiles treated with the litsea and lemon EO microemulsion showed strong antimicrobial activity against the skin associated microorganisms E. coli, S. aureus, S. epidermidis and T. rubrum and potential mosquito repellent properties.

SIGNIFICANCE AND IMPACT OF THE STUDY

EOs could be useful for the development of natural, environmentally friendly functional textiles to protect textiles and users from microbial contamination in addition to possessing other beneficial properties such as mosquito repellency.

Effects of heavy metal-mediated intraspecific variation in leaf litter on the feeding preferences of stream detritivores

Plant litter inputs from terrestrial ecosystems are indispensable resources for stream ecosystems. Heavy metal pollution in the environment may indirectly affect the food webs of streams by changing the traits of leaf litter. In the present study, willow leaf litter was collected in polluted and non-polluted sites (natural willow), and leaf litter was produced in the lab by exposing willow saplings to different concentrations of heavy metals in water (cultivated willow). The collected willow leaf litter was used for feeding preference experiments with stream detritivores (shrimps and snails). Metal pollution significantly decreased the lignin concentration and toughness of litter and increased Zn and Cd concentrations. Both detritivores preferred to consume metal-enriched litter, with their consumption rates of this litter being significantly higher than those of non-enriched litter. The toughness of the willow litter was the key factor determining the feeding preferences of shrimps and snails. The detritivores that consumed metal-enriched leaf litter contained more Zn and Cd in their bodies than those that consumed non-enriched litter. The Zn and Cd concentrations in shrimp faeces were higher for shrimps that consumed metal-enriched litter than for those that consumed non-enriched litter. The heavy metal concentrations and chemical oxygen demand (COD) of the water following litter consumption were significantly higher for the metal-enriched litter than for the non-enriched litter, resulting in decreased water quality in the former context. The specific resource allocation patterns that result from heavy metal pollution in the environment will have ecological consequences.

C2-C3 vertebral disc angle: An analysis of patients with and without cervical spondylotic myelopathy

STUDY DESIGN

Retrospective analysis.

OBJECTIVE

To define C2-C3 vertebral disc angle (VDA) in patients with and without cervical spondylotic myelopathy.

SUMMARY OF BACKGROUND DATA

C2-C3 VDA is a new radiological index of cervical spine alignment. Recent studies have suggested that high postoperative values are associated with greater mechanical complications in patients with cervical spondylotic myelopathy. However, normative values for patients without myelopathy has yet to be defined.

METHODS

Patients with and without cervical myelopathy between 2017 and 2019 were included. Inclusion criteria were patients above 18 years of age with antero-posterior (AP) and lateral (LAT) cervical X-rays. In the non-myelopathic group, patients were excluded if they had neurological symptoms or deficits, presence of cervical axial pain, previous spinal surgery, or diagnosis of either spondylolisthesis or scoliosis. In the myelopathic group, patients were excluded if they had previous spinal surgery. Radiological indices evaluated include: C2-C3 disc angle, C2-C7 Cobb angle, C7 sagittal vertical axis, T1 slope.

RESULTS

In total, 99 patients without myelopathy and 22 patients with myelopathy were identified and analyzed. In patients without myelopathy, the mean for C2-C3 VDA was 25.9±7.9. For patients with myelopathy, preoperative values were 24.4±10.0 and 27.1±7.9 postoperatively. No statistically significant differences were found between patients with and without myelopathy. C2-C3 disc angle was not correlated with age (R=-0.173).

CONCLUSION

This study did not find statistically significant differences in C2-C3 VDA values between patients with and without cervical myelopathy. This study provides normative data for C2-C3 vertebral disc angle in patients with and without cervical spondylotic myelopathy. Furthermore, C2-C3 vertebral disc angle may be independent from age.

[Effects of over-expressing heat shock protein 60 on marrow mesenchymal stem cells in the treatment of phosgene-induced acute lung injury]

Objective: To investigate the effect of heat shock protein 60 (HSP60) overexpression on the ability of bone marrow mesenchymal stem cells (MSCs) and its therapeutic effect on rats with phosgene induced acute lung injury. Methods: HSP60 was transfected into MSCs by adenovirus. Western blot was used to measure the expressions of HSP60 before and after transfection. CCK-8 assay was used to detect the activity of MSCs, flow cytometry was used to detect the apoptotic ability of MSCs, and Transwell assay was used to observe the migration ability of MSCs. Sixty SPF grade male SD rats were randomly divided into control group, phosgene exposure group (inhalation of phosgene for 5 min) , MSCs group (phosgene exposure, MSCs treatment group) and transfected MSCs group (phosgene exposure, overexpression of HSP60 MSCs treatment group) . The pathological changes of lung were observed by lung pathological section, lung wet dry ratio, the degree of pulmonary edema, the total cell count and total protein content of alveolar lavage fluid, the inflammatory changes of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in BALF and serum were observed. The data were analyzed by Graphpad Prism 8.0 software. Paired comparisons were performed by non paired t-test. One way ANOVA was used for comparison between groups. Results: The proliferation ability of MSCs transfected with HSP60[A= (0.69±0.05) ] was significantly higher than that of MSCs not transfected with HSP60[A= (0.27±0.02) ] (P<0.05) . Compared with the phosgene exposure group, the pulmonary edema and inflammatory factor infiltration of MSCs group and MSCs transfected group were reduced. However, compared with MSCs group, the degree of pulmonary edema in MSCs transfected group was significantly improved, the levels of inflammatory factors IL-6 and TNF-α were significantly decreased, and the total protein content and total cell count in bronchoalveolar lavage fluid were less (P<0.05) . Conclusion: MSCs transfected with HSP60 can enhance the ability of proliferation, anti apoptosis, migration and the curative effect in rats with phosgene induced acute lung injury.